| NPI | 1396003844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYMIE D CORIA Dentist 909-936-6213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52595) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2013-10-04 |